Radiation therapy for breast cancer and other conditions often leaves the breast tissue temporarily sensitive and the skin of the breast susceptible to physical friction. There may be no immediate side effects from individual radiation treatments given to the breast, but some patients may develop fleeting aches and pains in the breast. Patients usually develop a slight fatigue and some skin vulnerability that accumulates over the course of therapy. The most common side effect is the skin's reaction to radiation and to the chemotherapy that sometimes accompanies the radiation therapy. Most patients develop tenderness, dryness, reddening, and pruritis, or itching of the skin, after a few weeks. In other words, the radiation therapy may temporarily compromise the skin on the breast as well as the inner breast tissue itself, making these weaker than usual or at least more tender and sensitive to irritation and physical insult.
Following radiation therapy of the breast, patient care recommendations typically include cleanliness and preservation measures, such as keeping the skin clean and dry using warm water and neutral soap; avoiding extremes, such as high and low temperatures while bathing, trauma to the skin, sun exposure, shaving the treatment area with a sharp razor, perfumes, cosmetics, deodorants and so forth. Only prescribed or recommended creams and balms are allowed for daily maintenance.
Some patients develop a sunburn-like reaction with blistering and peeling of the skin. “Moist desquamation” can occur in the fold under the breast or in the fold between the breast and the arm, or in any area when the most radiation is given. A limited amount of moist desquamation may allow a person to continue treatment without interruption. When the degree is such that treatment must be interrupted, the skin usually heals enough within a week to allow radiation to be resumed. Skin side effects usually heal completely within a few weeks of completing radiation therapy. However, some skin reactions may take months to heal. Rarely, the skin is compromised (e.g., thinned or dried out) permanently.
There are also issues of slight swelling of the breast during radiation therapy. This can cause notable tenderness and other problems, but usually goes away within 6-12 months. The skin may darken during the course of radiation, similar to tanning from ultraviolet light, but in most cases this also fades gradually over 6-12 months. Most people receiving radiation suffer periodic aches and pains in the treated breast or the muscles surrounding the breast, even years after treatment has ended. The specific cause is unknown, but these pains are generally harmless. Very rarely, patients develop a more serious breakdown of the skin, fractures of the breastbone, or such severe pain in the breast that surgery is needed for treatment.
Radiation therapy given to the axillary lymph nodes can increase the risk of patients developing upper arm swelling from fluid retention (“lymphedema”) following axillary dissection. Radiation to this area can cause pain and loss of strength in the hand and arm for years after treatment as well as numbness and tingling.
For sore skin in the breast area following radiation therapy, comfort padding measures tend to be homemade. Commercially available means to comfort and pad these delicate tissues during and after radiation therapy are needed.